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things are going along rather nicely. just had my first bm and i didn't cuss or scream at anything. pain, check. back to bed and curled in fetal position, check. back on facebook, check. total duration - less than 5 minutes of praying . there is a lingering soreness from that first bm but it is a far cry from hell fire. im not going back to work till this goes away though, thats for damn sure. im not immobilized but i am in enough discomfort to not concentrate for 8+ hours at any given task.

ill be back at work sometime this week. i dont need the pain pills, only needed them the first day. guess we caught the buggers early enough.

i will go back for gardasil when i have money, thats for sure. i plan on starting that in november.

thank you all so much for your advice. if i have to go back and have this done in the future (which im sure will happen) i won't be as worried. I'll go as soon as i find out and i'll be more cautious sexually moving forward. thats right, condoms are a girl's best friend.

My doctor phoned me today to say my two biopsies were not worrisome and I don't need to go back for six months.

ps: I'm still no clear on what next2u had done to him by his doctor -- can you clarify?

umm, yeah. the dr went in and gave me a HRA (high resolution anoscopy) and he fulgurated the growths he came across. he did not mention dysplasia but he said the growths were non cancerous and they would most likely return. the growths were non cancerous, he did not mention lesions and they were caused by hpv. i will get clarification when i see him again in 2 weeks.

it's kinda hard to get info and clarification as well. miss p, why don't you drop some knowledge and clarify for those of us who have had the treatment and for those of us who will be going through the treatment? dysplasia is heavily linked to cancer in all my searches and i was not able to determine if all abnormal growths are dysplasia or if only cancerous (in any stage) growths are dysplasia.

Sorry, this post has gone on so long I'm not confident that what other doctors are doing to their patients is what is being done by my doctor -- for example in therms of HRA ability, when in fact they're using NON-HRA, just plain anoscopies. It's all unclear to me in this thread, most because a proper biopsy after an HRA should not require anesthesia.

Then there's the anal wart vs. dysplasia issues that I'm not sure patients here understand the difference, much less the doctors. And this is all part of the fact that there aren't proper protocols fully a decade later on the proper treatment of this issue in MSM patients.

There are so many red flags in this thread, and other threads like it, that I don't know even how to comment. Much of which patients haven't even educated themselves on these issues to know if they are seeing the appropriate doctor that deals primarily with MSM patients.

the first dr was kind of a douche and he did not perform a HRA, he went in and did a sigmoidoscopy and did not put me under for the procedure. that was painful. this was not an anoscopy. a better protocol would have been beautiful. im thinking of contacting my hospital and voicing concern over this but it may be wasted time as im sure im in in the minority here.

there are a lot of good drs around here that deal with MSMs but that would require a bit more of a journey for me. half of me wants to work with my dr to help him become a better dr through experience because i am his first hiv poz patient and he does what he can. he also cracks me up but is he a little wet behind the ears. the majority of his decisions around my health have been good and ive stuck with him. he also got me in with the only dr we know of that provides medical marijuana scripts to severely ill poz patients (my id dr has been in the field 20+ years).

i should have talked to my id dr about the growths. instead i spoke to my gp. now the 2 drs i saw after my gp were unnecessary but it did lead to the correct dr albeit 6 months and 3 visits later. the colorectal surgeon was amazing. he was very direct and handles clients from all over the palm springs and los angeles area (even san diego) so he has his hands up gay butts on a regular basis. i think he may be a homo himself and he said the same thing you did, there is not enough research or education for gay men's health.

so, i guess if i were to take away things from this experience it would be get to the dr when there is a problem. if you have internal growths (and sometimes you won't know unless you've been there) you should see (or be referred to) a colorectal surgeon first. if there are external growths than they can be removed by the dr or the dermatologist. just get there as soon as you find out and be sure to get checkups!

fuck, im just happy its over and the bms aren't too bad. ill take your stuff one step further and suggest it as a topic for my men's poz group.

and congrats on the news! good news is always welcome, worrying sucks :p

I found this info, and it's kinda interesting, I also found a lotta things I didn't know about this subject, I do hope it helps someone out @ least help them understand: If anything it's a very good read

I'm glad your recovery post-procedure is relatively mild and not as severe as some experience. I'm particularly glad--though not about the reasons--that you seem willing to be an activist on these issues of anal health in gay men. As I've posted elsewhere on this site before, the extremely high rate of anal cancer will, I believe, increase even more and become a major problem for HIV+ gay men, what with the extended life spans and the simultaneous accelerated aging that is now occurring because of HAART and/or HIV itself. That there still is no standardized medical protocol for all of this, that more GPs and IDs do not perform anal pap smears or believe in their usefulness, and that it is so extremely difficult to find colorectal specialists who are familiar with these issues and perform high-resolution anoscopies, remains a major scandal, in my opinion. We must fight to overcome these problems, just like in the early days of the HIV pandemic it was PWA's like Michael Callen and doctors like Joe Sonnabend who fought the F.D.A. to standardize the use of Bactrim as a PCP prophylaxis over the somewhat useless aerosolized pentamidine.

However, I must admit that I remain as puzzled as Miss P about your particular problem(s) and what your doctor has done.

You've talked about warts, dysplasia, and even hemorrhoids. Now, when you talk about the "growths" he fulgurated, what exactly were they? Perhaps you could ask him specifically when next you see him. Dysplasias are, indeed, abnormal cell growths that are commonly referred to as lesions. They are PRE-cancerous and MAY become cancerous. Dysplasias are classified as minor, moderate, or severe. It is generally agreed that severe dysplasias should be destroyed. It is still a matter of debate whether minor or moderate dysplasias should be destroyed or just followed by further additional HRAs. (The accelerated-aging problem, though, is anecdotally causing an extremely rapid progression, much faster than regularly seen, from minor and moderate to severe amongst HIV+ gay men.)

What really baffles me even more now is your statement that "he said the growths were non cancerous." I would suggest you also ask him about this, because the only way he could determine this would be by having a biopsy done of some of the tissue he fulgurated. The tissue would have to be sent to a pathology lab, and the biopsy would not normally be completed while the anoscope was inserted and you were anesthetized. It usually takes a week or so for biopsy results. Once again, though, "non cancerous" does NOT mean the samples could not be PRE-cancerous. And the all-important dysplasia classification of mild, moderate, or severe can be determined only via biopsy.

« Last Edit: September 25, 2011, 05:55:20 AM by edfu »

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"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

With ever tightening bottom clenching I have finally read the whole thread. It is a very useful, important piece , I wish I had had the equivalent before chemo etc , so thanks Next and all who contributed . I am sending get well big time thoughts to you, Next .t

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"If we can find the money to kill people, we can find the money to help people ." Tony Benn

So should I assume that there was a video attached to the anoscopy and you could watch what the doctor was seeing in terms of lesions on a video screen next to the chair/stirrups you were in?

i dunno. ill get all the facts straight at my next check up. the colorectal specialist said he was going to do a HRA and he put something up my butt before he did this also (2 separate visits). There was not a screen in the room but he did see something and it was not as painful as the procedure before.

when i met with the gastroeneterologist i was able to see up my butt (not something i particularly enjoyed seeing as it was accompanied with a lot of pain as he filled my bum with air) because the device he was using during my sigmoidoscopy was hooked up to the monitor.

What really baffles me even more now is your statement that "he said the growths were non cancerous." I would suggest you also ask him about this, because the only way he could determine this would be by having a biopsy done of some of the tissue he fulgurated. The tissue would have to be sent to a pathology lab, and the biopsy would not normally be completed while the anoscope was inserted and you were anesthetized. It usually takes a week or so for biopsy results. Once again, though, "non cancerous" does NOT mean the samples could not be PRE-cancerous. And the all-important dysplasia classification of mild, moderate, or severe can be determined only via biopsy.

when i saw the dermatologist he had the growths he removed biopsied. the results were non-cancerous. I will get clarification as well. I'm not sure if the colorectal surgeon had biopsies ordered as well but i will find out and follow up accordingly.

so the day after the procedure the agony was gone. what i hadn't wrapped my pea-sized brain around was the daily reoccurring pain from the bms (bowel movements). everyday they are becoming less and less severe. its kind of a dull general pain, more discomfort than pain, that can last for an hour or 2 after the bm. immediately after the bm i head to my bedroom and assume the fetal position.

after 5-15 minutes things return to normal and i have this dull accompanying pain/discomfort for an hour or two.

but lets talk about today's discovery and the importance of healthy eating during recovery. so, last night i had a craving for shit food from a gas station. this morning i had diarrhea. Not the bad stuff fueled by med nightmares, just 2 additional trips to the john. what this meant was a lot of pain come bm number three. too many bms in a short period of time are murder. on the third bm i was clutching the toilet paper roll about to rediscover religion.

the duration of the dull pain has also been longer because of the amount of times my rectum had shit passed through it.

i dunno. ill get all the facts straight at my next check up. the colorectal specialist said he was going to do a HRA and he put something up my butt before he did this also (2 separate visits). There was not a screen in the room but he did see something and it was not as painful as the procedure before.

when i met with the gastroeneterologist i was able to see up my butt (not something i particularly enjoyed seeing as it was accompanied with a lot of pain as he filled my bum with air) because the device he was using during my sigmoidoscopy was hooked up to the monitor.

Sounds like a regular anoscopy then, not a HRA. I hate to be a pessimist with you, but either you're not clear on everything going on with this doctor or the doctor isn't clear... or something. I don't even know what you're referring to by "growths" -- are discussing anal dysplasia or something different? Anal dysplasia is a lesion, not a growth.

meet with the surgeon today. that guy is pretty awesome. he answered the door and had me wait for a moment. then he took me to the back and reviewed my lab results with me and answered my questions. he spent damn near an hour with me and get this, i didn't have an appointment!!!!

i had low grade dysplasia (aka the growths). it was caused by hpv and was benign. he said the condyloma was removed by surgery and that the surgery involved cauterization. during my first office visit he gave me an anoscopy and when i was under anesthesia during surgery he gave me an hra.

he recommends a yearly anoscopy, a hra every 5 years and that i get vaccinated with gardasil.

i don't think my insurance company approved my vaccination with gardasil but when i went to my dr's office today to get my flu shot they had two syringes for me, one with a flu vaccination and the other was gardasil. guess i have to see how much they will charge me and hopefully get my insurance company to pay a portion of it.

and my two copays for this procedure have come to just under $1000. talk about a slap in the face and a pain in the ass. i have to look for other health insurance options.

i dunno, when i was hospitalized after the heart episode a few years back i only paid $700 out of pocket for a two day stay and the tab was $26,000. i was at the hospital getting these buggers rotor-rooted out and i think it came to $3000 and im paying $1000 out of pocket.

i know my plan has changed but fuck . i guess that'll be another week of deciphering medical records and picking out a new plan for 2013 (enrollment and changes for health plans for 2012 have already passed).

Oops, should have logged in earlier. I've posted a few times about this, but I'm still surprised so many HPV/HIV+ men are treated with surgery for this. Infrared Coagulation is far less invasive and usually less painful:

IRC is a very simple and effective procedure to treat mild to moderate cases of anal dysplasia or warts of the anal canal. The procedure takes place in our office and has minimal discomfort to you. This procedure is done using High Resolution Anoscopy only after the diagnosis of dysplasia and or warts have been confirmed.http://www.oicorlando.com/anal-dysplasia.html

"IRC is a very simple and effective procedure to treat mild to moderate cases of anal dysplasia or warts of the anal canal. The procedure takes place in our office and has minimal discomfort to you. This procedure is done using High Resolution Anoscopy only after the diagnosis of dysplasia and or warts have been confirmed."http://www.oicorlando.com/anal-dysplasia.html

----------All-RIGHT! The incomparable Dr. Edwin DeJesus, who has appeared on this site before, in 2008 :

How fortunate you are to be able to be subject to his kind ministrations, and that his medical practice is so completely aware of what needs to be done regarding anal dysplasia for the HIV+. Would that every HIV practice in the U.S. were so competent.

« Last Edit: November 07, 2011, 05:32:39 AM by edfu »

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"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

All-RIGHT! The incomparable Dr. Edwin DeJesus, who has appeared on this site before, in 2008 :

He's porked up a bit over the past several years, don't you think? Workin' that pernil and red beans diet, fo' sure.

Still, if anyone in Orlando needs a doctor that's where he's practicing currently. Can't find him on facebook, unlike Frank who we all know gets around. Seriously girl, what is this look she's trying to work? So not featured!

(You'll note I had a recent exchange with him there about the HPV vaccine.)

I just read your comment regarding his post. I've also still not seen a proper explanation regarding this year's "trend" about recommending Gardasil to HIV+ men that are already infected with the strains of HPV that this vaccine protects. It's redundant and a waste of money as far as I can see. Where are the studies showing any beneficial outcome? Frank's just a general internist anyway.

I will pick my colorectal specialist's brain about this topic during my next visit. He's also friends with my specialist I had when I lived in NYC, who I know participated in the Gardasil trials so I want to know his opinion as well. As far as I know Dr. Joel Palefsky, UCSF, that's done so much with this topic says it has zero benefit for men already infected with those four strains. The issue for such patients isn't prevention itself (obviously), but lessening any recurrence of dysplasia.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

So, I had a little follow up procedure this last Friday. The little fuckers wont stay away this time! So, I've been in a shitload of pain and I finally figured out why yesterday. I have an external hemorrhoid.

My colorectal dr told me during one of my first visits that I had hemorrhoids. I didn't know because they were internal. Fast forward to five days ago. I took the biggest, hardest shit I've taken in YEARS. Like, Lamaze inducing shit fit, thinking about pregnancy and whether women were the stronger sex shit fit and a whole bunch of other anal-centric thoughts that i won't mention.

Less than 48 hours later my colorectal dr is removing two small critters. I go home, have diarrhea and fuck, my ass has been in pain since. It is healing from the removal of the critters (excision and cauterization) and my first external hemorrhoid.

My ass hurts worse than it ever has. I've been laying on my side for two days now fearing bowel movements. This time I needed pain meds and baby wipes (thank you Ann, you are an ass saver).

God, I have to be up for work in 4 hours. My ass is still throbbing and I don't know how to fix it. This sucks. I've been drinking more water and will start eating more fiber.

My dr wants me to start this aldera stuff but now I'm loathe to do anything as my ass appears to be under attack. I haven't bottomed in over a year, what the fuck. Ass, please go back to normal soon, this really sucks.

Any practical advice is appreciated. I'm showering more cause it makes the pain go away and I'm using a triple antibiotic after showering cause the lubrication helps and I've bleed a bit. I'm fearful of infections as well. Will this really take a month to two months to heal? I will ask my dr for more info when I see him for my follow up in two weeks as well.

I've been called a lot of things in my day ( sometimes including the word ass), but never an ass saver. Guess there's a first time for everything!

I hope this clears up for you ass soon ass passible.

If you have to sit a lot at work but don't have one of those doughnut shaped cushions, you may be able to make a reasonable substitute by using two or three strategically placed cushions, or even a couple of rolled up towels. It might make others laugh, but screw them, they're not the ones in pain.

If you don't start feeling better soon, don't take it sitting down - get in touch with your doctor to see what else may be done.

Just be careful with the painkillers - opiate based meds (like codeine) can make you constipated and make things worse for you. It may actually be worth foregoing the painkillers for a day or three if they're making you constipated. Passing rock-hard stools will only hinder the healing process.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

And what the fuck is up with these muscle spasms? Does my sphincter know no mercy!

"D" everyone get hemorrhoids, I have an external one on my left side ( as well as a groin muscle pull too) I've had for a week now, it it hurts like a mofo, I'm currently sitting on a pillow as I type this post, I've done a lotta hot-tub-baths, and I'm gonna get rid of this sucker soon ( I hope) Bob keeps laughing @ me the way I'm walking around the house right now

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Its well known that one must sometimes suffer for beauty. You're getting rid of all the invaders and eventually your dude-erus, your bulging ol' brown eye, will be transformed back into a seductive silk man purse, ready for action once again.

I hope it comes soon for you. Keep your mind off it by whatever means possible. You're a hero for taking care of business, at least!

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ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Wtf, has anyone here had good results with Aldara? Based on the thread above it seems like it comes with a host of problems. My shit was just removed and I'm not in the mood for anymore butt torture anytime soon.

I'm supposed to start it in 10 days. Is it always painful? My dr hinted that there might be some discomfort but it sounds like there will be great discomfort. He prescribed it to me to prevent another immediate outbreak and to stimulate my immune response down there.

Wtf, has anyone here had good results with Aldara? Based on the thread above it seems like it comes with a host of problems. My shit was just removed and I'm not in the mood for anymore butt torture anytime soon.

I'm supposed to start it in 10 days. Is it always painful? My dr hinted that there might be some discomfort but it sounds like there will be great discomfort. He prescribed it to me to prevent another immediate outbreak and to stimulate my immune response down there.

Regards,d

It stops them from growing back so you won't have to go through all this again, right? If that's the case seems like an easy answer.

I didn't realize Aldara could be used as a preventative measure. Personally, I'd rather wait til they returned and have them zapped again, rather than use that cream. I had severe burning issues with it.

I had a huge internal roid that was protruding out that had to be surgically removed this past Spring. Of all the BS I've been through, this was by far the worst. I had spinal taps every week for 2 months that felt like a cake walk compared to the recovery of that surgery. They also removed some polyps and highgrade AIN warts.

The first 2 weeks were the worst and then gradually got easier. I just made sure I was never more than a few feet from a restroom. And I ALWAYS started filling the tub with hot water prior to doing my business. I avoided eating because I didn't want to have BM's.

Thanks for the info-linky on the hemorrhoids Ray I always get them, but they always go away on their own

WOW Greg I hope I never have to get any hemorrhoids removed, sure doesn't sound like a walk in the park to me I don't even enjoy anal-sex all that much maybe once or twice a yr. are during times of lint

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

WOW Greg I hope I never have to get any hemorrhoids removed, sure doesn't sound like a walk in the park to me I don't even enjoy anal-sex all that much maybe once or twice a yr. are during times of lint

Not sure what anal sex has to do with it unless someone is penetrating you with a switchblade.